Mannitol and renal graft injury in patients undergoing deceased donor renal transplantation - a randomized controlled clinical trial.
Reiterer, C., et al.BMC Nephrology 2020; 21(1): 307.
Aims
This study aimed to assess the effect of mannitol in reducing ischaemia/reperfusion (I/R) injury during reperfusion of the renal graft in kidney transplant patients.
Interventions
Participants were randomized to either the mannitol group or the NaCl placebo group.
Participants
34 deceased donor kidney transplant patients.
Outcomes
This small double-blind study investigated the role of mannitol in the reduction of ischaemia-reperfusion injury (IRI) following deceased donor transplantation. Recipients were randomized to 20% mannitol or placebo before, during and after graft reperfusion, and the effect on biomarkers of IRI was assessed. Only minor changes in biomarker profiles were observed, leading the authors to conclude that routine use of mannitol in renal transplantation is not justified. Whilst the study design is generally good (double-blind, placebo controlled), the sample size is small and underpowered to show d
Follow-up
24 hours
CET Conclusions
This small double-blind study investigated the role of mannitol in the reduction of ischaemia-reperfusion injury (IRI) following deceased donor transplantation. Recipients were randomized to 20% mannitol or placebo before, during and after graft reperfusion, and the effect on biomarkers of IRI was assessed. Only minor changes in biomarker profiles were observed, leading the authors to conclude that routine use of mannitol in renal transplantation is not justified. Whilst the study design is generally good (double-blind, placebo controlled), the sample size is small and underpowered to show differences in clinical outcomes such as GFR or DGF. Nonetheless, this study opens an interesting debate about a longstanding practice in renal transplantation with limited supporting evidence.
Data analysis
Available case analysis
Trial registration
ClinicalTrials.gov - NCT02705573